| NPI | 1164159067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL APRN11020874) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11020874) | 
| Enumeration Date | 2022-08-02 | 
| Last Update Date | 2022-08-02 |